Borderline Personality Disorder is in my opinion one of the most misunderstood, stigmatised and complex mental health diagnoses. One could write pages relating to the condition and a layman’s understanding would still be incomplete! For this reason I am going to try and keep this page as short, simple and concise as I can, and I will try and relate my writing back to my own experiences as much as possible.
What BPD feels/looks like:
- Intense feelings of loneliness and an inability to sit with myself without resorting to poor coping behaviours.
- Extreme emotional vulnerability and sensitivity, and hence feelings of severe internal distress often triggered by apparently ‘menial’ stimuli.
- Slow return to baseline: strong emotions and cognitions which are evoked in me tend to take a very long time to dissipate and can torment me for hours or days.
- Feelings of ‘dying inside’, immense emotional turbulence and pain, distress beyond explanation and feeling as though my emotions are so impossible to live with that they will surely kill me.
- My emotions are in control of me, I am not in control of my emotional world.
- Impulsive behaviours and an inability to ‘think before I act’ and ‘learn from my mistakes’ time and time again.
- Extreme and rapid mood swings ranging from debilitating periods of depression to somewhat dysphoric and delusional bouts of mania.
- Paranoia and anxiety, especially in interpersonal circumstances.
- Problems with ‘attachment’ especially with authority and care-giver figures e.g. therapists, teachers, etc. Subsequent and related feelings of insatiable neediness, cravings for attention, and jealousy of others who “threaten” the chances of my needs being met in these circumstances.
- A history of suicidal ideation, tendencies and threats.
- Multiple short and long-term admissions to A&E, hospitals and other institutions.
- Risk-taking and thrill-seeking behaviours as well as chronic boundary-pushing and rule-breaking, especially with authority figures/ in institutional settings.
- Extreme struggles with (real and/or perceived) abandonment, rejection, disappointment, and hence going to any lengths to avoid this.
- Self-destructive tendencies, especially self-injurious behaviour (SIB) mostly through cutting. This has also manifested through eating disordered behaviours, alcohol and drug abuse. Others may struggle with sex, spending, gambling, and other addictive behaviours.
- Lack of sense of self: constantly having to define myself based on my external world and lacking a fundamental secure sense of a ‘true me’. Only being able to have an idea of who I am by looking at evidence and cues in the people and world around me, and/or defining myself by my external abilities and achievements only.
- Struggles with dissociation and suffering from periods of derealisation (feeling as though the world around me is not real, is foggy, distant and impossible to reach) and depersonalisation (feeling as though I do not exist, am not in my body, and am not in control of my thoughts or actions).
- Difficulties with appropriately expressing my anger, often leading to heightened displays and outbursts of intense pent-up emotion.
- A highly severe guilt and shame complex in response to every imperfect interaction or perceived personal failure.
- Feelings of self-hatred, self-loathing, hopelessness, despair, especially in response to making mistakes that impact those around me.
- Black-and-white/ all-or-nothing thinking patterns as well as the tendency to engage in ‘catastrophic thinking’, ‘mind-reading’ and jumping to conclusions.
- High perceptiveness of people and circumstances around me, to the point of unhealthy and paranoid hyper-vigilance.
- Feelings of being misunderstood by the world and people around me and of ‘never fitting in’, always being on a different wave-length to my fellow demographical counterparts.
- ‘Splitting’: rapidly changing perceptions of myself and people around me from one extreme to the other, and an inability to hold two opposing potential truths in mind.
- Manipulative behaviours such as playing people in my life off against each other, asking multiple people the same thing until I receive the answer I am looking for, convolutedly threatening self-destructive tendencies if my needs remain unmet, etc.
In DBT, the belief is that BPD arises due to the transaction between an individual’s emotional vulnerability, and an (early) invalidating environment. This theory is known as the Biosocial Model.